Prevalence of GHB-Related Presentations to a Metropolitan Emergency Department in Melbourne.

Introduction: Gamma-hydroxybutyrate (GHB) is a commonly used recreational substance. It has a narrow therapeutic index. The management of GHB overdose in the emergency department (ED) is labour and resource intensive. This study aims to provide a comprehensive analysis of GHB presentations at one of Victoria's largest tertiary hospitals.

Methodology: We conducted a retrospective study on GHB-related ED presentations between 2014 and 2024 and reported a case series of admissions to the Intensive Care Unit (ICU). For ICU admitted patients, confirmation of GHB presence in blood was collected through the Emerging Drug Network of Australia-Victoria (EDNAV) study.

Results: We recorded 2631 cases of GHB-related presentations. The median age was 29 years and 42.3% of cases were female. The presentations of individuals under 25 years of age declined from 61.4% to 14.0%. The majority of patients (81.0%) were brought in by ambulance, with 12.5% accompanied by police. Most patients (93.9%) were managed and discharged from the ED or Short Stay Unit. Only a small proportion of patients (108, 4.1%) required ICU admission. The median stay in the ICU was 2 days. 88.7% of cases admitted to the ICU required intubation. Eight ICU-admitted patients, recruited for the EDNAV study, had a confirmed presence of GHB and other co-ingestions.

Discussion: Our study showed a significant increase in GHB-related presentations to our ED. There has been a notable shift in the demographics of patients presenting to EDs with GHB-related issues. GHB use poses a significant impact on EDs and intensive care services.